Basic Information
| Provider Information | |||||||||
| NPI: | 1194397372 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BONAPARTE | ||||||||
| FirstName: | SHYRONDA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4337 S 52ND ST | ||||||||
| Address2: | |||||||||
| City: | TACOMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 984091800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7065503595 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1305 TACOMA AVE S | ||||||||
| Address2: | |||||||||
| City: | TACOMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 984021903 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2533965823 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/15/2021 | ||||||||
| LastUpdateDate: | 06/08/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/08/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 246Y00000X | N | Technologists, Technicians & Other Technical Service Providers | Spec/Tech, Health Info | 247000000X | N | Technologists, Technicians & Other Technical Service Providers | Technician, Health Information | 101Y00000X | WA | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.